Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,950.46 / $8,965.00	Facility		$100.00	$1,950.46	$8,965.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,462.85 / $1,462.85 / $1,654.42	Facility	54	$1,462.85	$1,462.85	$1,654.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.88 / $643.89 / $1,661.06	Professional		$562.88	$643.89	$1,661.06
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $422.16 / $482.92 / $1,245.80	Professional	54	$422.16	$482.92	$1,245.80
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $84.43 / $96.58 / $249.16	Professional	55	$84.43	$96.58	$249.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,449.90 / $1,611.00 / $3,700.00	Facility		$1,449.90	$1,611.00	$3,700.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $581.27 / $892.03 / $1,293.44	Professional		$581.27	$892.03	$1,293.44
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $871.90 / $1,338.04 / $1,940.16	Professional	50	$871.90	$1,338.04	$1,940.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $767.18 / $1,086.68 / $1,625.43	Professional		$767.18	$1,086.68	$1,625.43
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $763.56 / $1,267.78 / $2,356.73	Professional		$763.56	$1,267.78	$2,356.73
United Facility/Professional Facility Modifier Low / Median / High Price $8,611.00 / $8,611.00 / $8,611.00	Facility		$8,611.00	$8,611.00	$8,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $792.62 / $1,040.20 / $2,014.16	Professional		$792.62	$1,040.20	$2,014.16
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $472.65 / $552.05 / $661.71	Professional		$472.65	$552.05	$661.71